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IAI Accepted Manuscript Posted Online 22 July 2019 Infect. Immun. doi:10.1128/IAI.00528-19 Copyright © 2019 American Society for Microbiology. All Rights Reserved. Downloaded from 1 Peptidyl-, ppiB, is essential for proteome homeostasis and

2 virulence in Burkholderia pseudomallei

3

1 2 3 3

4 Nicole M. Bzdyl , Nichollas E. Scott , Isobel H. Norville , Andrew E. Scott , Timothy http://iai.asm.org/

5 Atkins3, Stanley Pang4, Derek S. Sarovich5, Geoffrey Coombs4,6, Timothy J. J. Inglis1,6,7,

6 Charlene M. Kahler1 and Mitali Sarkar-Tyson1

7 on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 8 1Marshall Centre for Infectious Diseases Research and Training, School of Biomedical

9 Sciences, University of Western Australia, Perth, WA, Australia

10 2Department of Microbiology and Immunology, University of Melbourne at the Peter

11 Doherty Institute for Infection and Immunity, Parkville, VIC 3010 Australia

12 3Defence Science Technology Laboratory (Dstl), Porton Down, Salisbury, United

13 Kingdom

14 4School of Veterinary and Life Sciences, Murdoch University, Murdoch, Australia.

15 5GeneCology Research Centre, University of the Sunshine Coast, Sippy Downs, QLD,

16 Australia

17 6PathWest Laboratory Medicine WA, Perth, WA, Australia

18 7School of Medicine, University of Western Australia, Perth, WA, Australia

19

20 Correspondence Address: 1

Downloaded from 21 Dr Mitali Sarkar-Tyson

22 Marshall Centre for Infectious Diseases Research and Training

23 School of Biomedical Sciences

24 University of Western Australia http://iai.asm.org/

25 Perth, WA, Australia

26 E-mail: [email protected]

27 Tel: +61 8 6457 4872 on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209

28

2

Downloaded from 29 Abstract

30 Burkholderia pseudomallei is the causative agent of melioidosis, a disease endemic in

31 South-East Asia and northern Australia. Mortality rates in these areas are high even

32 with antimicrobial treatment, and there are few options for effective therapy. Therefore http://iai.asm.org/ 33 there is a requirement to identify anti-bacterial targets for the development of novel

34 treatments. are a family of highly conserved important in multiple

35 cellular processes. Cyclophilins catalyse the cis-trans isomerization of xaa-

36 bonds, a rate limiting step in protein folding which has been shown to be important for on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 37 bacterial virulence. B. pseudomallei encodes a putative B , ppiB, the

38 role of which was investigated. A mutant strain, BpsΔppiB, demonstrates impaired

39 biofilm formation and reduced motility. Macrophage invasion and survival assays

40 showed that although BpsΔppiB retained the ability to infect macrophages, it had

41 reduced survival and lacked the ability to spread cell-to-cell, indicating ppiB is essential

42 for B. pseudomallei virulence. This is reflected in the BALB/c mouse infection model

43 demonstrating the requirement of ppiB for in vivo disease dissemination and

44 progression. Proteomic analysis demonstrates that the loss of PpiB leads to pleiotropic

45 effects supporting the role of PpiB in maintaining proteome homeostasis. The loss of

46 PpiB leads to decreased abundance of multiple virulence determinants including

47 flagellar machinery and alterations in Type VI secretion system proteins. In addition, the

48 loss of ppiB leads to increased sensitivity towards multiple antibiotics including

49 meropenem and doxycycline, highlighting ppiB inhibition as a promising anti-virulence

50 target to both treat B. pseudomallei infections and increase antibiotic efficacy.

51 3

Downloaded from 52 Introduction

53 Burkholderia pseudomallei is a Gram-negative soil saprophyte found in tropical and

54 sub-tropical areas around the world such as in South-East Asia and northern Australia

55 (1-3). It is the causative agent of melioidosis and has been reported in 45 countries with http://iai.asm.org/ 56 a predicted global burden of 165,000 cases and 89,000 deaths annually (4). Melioidosis

57 can present as a variety of clinical syndromes ranging from non-healing skin lesions to

58 intra-abdominal abscesses to pneumonia and septicaemia (5), leading to difficulty in

59 prompt diagnosis particularly in non-endemic regions. Mortality rates vary depending on on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 60 geographic location with rates ranging from 14% in Darwin (5) to 49% in North-East

61 Thailand (6). Treatment of melioidosis is prolonged, consisting of two phases; a two-

62 week intensive intravenous phase followed by a 3 to 6-month oral eradication phase (7,

63 8). Due to intrinsic resistance to antimicrobials (9) treatment of B. pseudomallei infection

64 can be further complicated by the limited number of viable antimicrobial alternatives.

65 Relapse of infection is common and is associated with increased mortality, particularly

66 in cases were treatment is unsuccessful or an incomplete course of antimicrobial

67 therapy is taken (10, 11).

68 B. pseudomallei infections can be difficult to overcome due to the bacterium encoding

69 for an array of defence mechanisms which enables successful survival in diverse

70 environments including inside mammalian host cells. The ability of B. pseudomallei to

71 form biofilms allows it to persist in the environment and has been implicated in infection

72 (12-14). B. pseudomallei encodes flagellin, important for disease dissemination and

73 virulence in BALB/c mouse infection models (15, 16). Intracellular survival is reliant on

74 B. pseudomallei rapidly escaping from the phagolysosome and establishing a replicative 4

Downloaded from 75 niche in the cytosol of eukaryotic cells (17). The ability to escape into the cytosol is

76 dependent on multiple secretion systems which function to deliver specialised secreted

77 proteins known as effectors into the host which enhance bacterial survival and enable

78 the spread of B. pseudomallei into neighbouring cells (18). Three different Type-III http://iai.asm.org/ 79 Secretion Systems (T3SS-1, -2, -3) are found in B. pseudomallei with only T3SS-3

80 required for full virulence in a hamster model of infection (17, 19-21). Following

81 phagosome escape and replication in the cytosol, expression of Type-VI Secretion

82 Systems (T6SS) is induced and is essential for in vivo virulence (22-24). A well- on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 83 documented phenomena of B. pseudomallei is the formation of multinucleated giant

84 cells (MNGC). This formation has been attributed to the T6SS-5 (T6SS Cluster 1)

85 effector VgrG-5 which is required to stimulate cell fusion and leading to the spread of

86 infection (22, 25, 26). Six clusters of T6SS are found in B. pseudomallei with T6SS

87 Cluster 1, as defined by Shalom et al (24) as tss5, shown to play a role in the formation

88 of MNGC and cellular cytotoxicity (26, 27) Throughout this paper the Schell et al (28)

89 nomenclature for T6SS will be used .

90

91 Cyclophilins are part of the immunophilin superfamily, with generally encoding

92 two cyclophilin , ppiA and ppiB with one located in the cytoplasm and the other in

93 the periplasm or outer membrane respectively (29). Cyclophilins catalyse the cis-trans

94 isomerisation of xaa-proline bonds, a rate limiting step in protein folding, which is

95 required for proteome homeostasis (30, 31). Not only are cyclophilins required for

96 optimal protein folding but in multiple bacterial systems cyclophilins are important for

97 stress response and infectivity, suggesting a role in folding virulence factors. In Brucella 5

Downloaded from 98 abortus the expression of both CypA and CypB become elevated during intracellular

99 infection with deletion of these genes resulting in virulence attenuation, reduced

100 intracellular survival and increased susceptibility to acidic and oxidative stress (32).

101 Further evidence of the role of cyclophilins in virulence is demonstrated in Legionella http://iai.asm.org/ 102 pneumophila where the cyclophilin gene cyp18 is essential for optimal intracellular

103 survival in Acanthaemoba castellanii (33). Cyclophilins also play an important role in

104 biofilm formation with ppiB shown to be a negative regulator of both

105 motility and biofilm formation, mutagenesis of E. coli ppiB results in hypermotility and on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 106 increased biofilm formation (34). The pleiotropic role of cyclophilins in bacteria is also

107 demonstrated in E. coli where interaction of PpiB with the protein, FtsZ, is important for

108 correct cell division, with deletion of ppiB resulting in aberrant cell division and formation

109 of filamentous cells (35).

110

111 B. pseudomallei encodes a ppiB gene, the role of which was investigated by

112 construction of a null mutant strain Bps∆ppiB. In vitro characterisation of Bps∆ppiB

113 demonstrates a loss of multiple virulence determinants including reduced motility and

114 biofilm production. Intracellular survival of Bps∆ppiB was significantly reduced with

115 bacteria confined within the macrophage cell, lacking the ability to spread cell-to-cell,

116 indicating ppiB is important for B. pseudomallei virulence. This is reflected in the BALB/c

117 mouse infection model in which BpsΔppiB was avirulent, demonstrating the important

118 role for ppiB in in vivo disease dissemination and progression. Proteomic analysis

119 confirms widespread alterations within BpsΔppiB, that are partially restored by

120 complementation of ppiB. Consistent with this, complementation restored 6

Downloaded from 121 multinucleated cell formation and cell disruption. Finally, we demonstrate that loss of

122 ppiB leads to increased susceptibly to first-line treatment antibiotics such as

123 meropenem and doxycycline. Thus, this study shows the importance of ppiB for

124 virulence of B. pseudomallei and how disruption of proteome homeostasis may be http://iai.asm.org/ 125 targeted to sensitize B. pseudomallei to antibiotic regimes.

126

127 Results

128 Deletion of ppiB gene in B. pseudomallei. on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209

129 BPSL2246 (UnitProt Entry Q63SS5) encodes a putative cytoplasmic cyclophilin, ppiB

130 homologue in B. pseudomallei (Supplementary Fig 1). There is 66.3% and 57.7%

131 protein identity with cyclophilin B homologues from E. coli and L. pneumophila

132 respectively, with residues involved in enzymatic activity also being conserved

133 (Supplementary Fig 1) (36). To determine the role of ppiB in B. pseudomallei strain

134 K96243, the gene was deleted by construction of an in-frame null mutation strain,

135 Bps∆ppiB (37). Deletion of ppiB in Bps∆ppiB was confirmed by whole genome

136 sequencing. In comparison to the parent K96243, strain there was one additional SNP

137 in Bps∆ppiB that resulted in a missense mutation in rpoZ (RpoZLeu10Pro). No differences

138 in growth were observed between the BpsWT and Bps∆ppiB mutant strain in either

139 Luria Bertani broth or M9 minimal media (Supplementary Fig 2).

140

141 Bps∆ppiB can infect mouse murine macrophage cells in vitro but has reduced

142 intracellular numbers 6 and 9 hours post infection. 7

Downloaded from 143 Mouse murine macrophages, J774.1 cells, were infected with either the wild-type or

144 Bps∆ppiB strain, bacteria were enumerated at various time points post infection (Fig 1).

145 There were no significant differences in the levels of adherence and invasion of

146 macrophages (data not shown). Significant differences in the numbers of intracellular http://iai.asm.org/ 147 bacteria at 6 (14-fold, P-value 0.0159, Mann Whitney U-test) and 9 (36.8-fold, P-value

148 0.0159, Mann Whitney U-test) hours post infection were seen with Bps∆ppiB

149 demonstrating reduced survival and/or replication. At 12 hours Bps∆ppiB was able to

150 overcome the reduced growth phenotype showing similar levels of intracellular bacteria on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 151 to that of the BpsWT parental control. At 24 hours although the levels of intracellular

152 bacteria in both BpsWT and Bps∆ppiB appears to be similar, there was a substantial

153 reduction in cell cytotoxicity caused by Bps∆ppiB compared to BpsWT using LDH

154 cytotoxicity screening (Supplementary Fig 3). Together these results demonstrate

155 Bps∆ppiB has reduced growth and/or survival in macrophage cells.

156

157 ppiB is essential for in vivo infection

158 As in vitro results demonstrated a decrease in intracellular counts during early time

159 points the role of ppiB during infection was further investigated using the BALB/c mouse

160 infection model of B. pseudomallei. Groups of mice were challenged by the

161 intraperitoneal route with either BpsWT or BpsΔppiB (Fig 2A). At the end of the

162 experiment 100% of the animals challenged with Bps∆ppiB survived compared to 33%

163 in the group challenged with BpsWT (P-value 0.0183 by Log-rank (Mantel-Cox) test).

164 Disease progression was also monitored by measuring weight loss during the infection

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Downloaded from 165 study, all except two mice infected with BpsWT showed considerable weight loss (Fig

166 2B). In contrast, mice infected with BpsΔppiB demonstrated no weight loss throughout

167 the experiment (Figs 2C). The lungs, livers and spleens in survivors were enumerated

168 for bacteraemia, all were clear from infection at the conclusion of the experiment. This http://iai.asm.org/ 169 demonstrates that ppiB is essential for B. pseudomallei to successfully establish in vivo

170 infection.

171

172 BpsΔppiB demonstrates reduced ability to form MNGC. on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209

173 The in vitro cell infection study suggests BpsΔppiB is attenuated, in contrast the mouse

174 infection studies demonstrate that BpsΔppiB is avirulent. To investigate this in more

175 detail a complemented strain was constructed, BpsΔppiB/ppiB, and was further

176 characterised in macrophage cells. BpsWT, Bps∆ppiB, Bps∆ppiB/ppiB infected cells

177 were analysed by immunofluorescence microscopy 12 hours post infection. Fig 3A

178 shows that during a later time point of 12 hours post infection, macrophage cells

179 infected with BpsWT has multiple MNGC formations. In contrast, Bps∆ppiB infected

180 cells demonstrate a significant reduction in multinucleated giant cell (MNGC) formation,

181 although actin protrusions are still observed (Fig 3B). Complementation of ppiB

182 demonstrates restoration to a BpsWT phenotype (Fig 3C). Enumeration of nuclei within

183 multi-nucleated cells relative to mononucleated cells shows that there is a 67.4%

184 reduction in nuclei associated with MNGCs in macrophage monolayers infected with

185 Bps∆ppiB, this is significantly restored in the complemented strain, Bps∆ppiB/ppiB (Fig

9

Downloaded from 186 3D), confirming the role of ppiB in the virulence of B. pseudomallei during intracellular

187 infection.

188

189 BpsΔppiB reveals marked changes in the proteome http://iai.asm.org/

190 To understand the changes driving the alterations in virulence, we analysed the

191 proteome of Bps∆ppiB, its complement Bps∆ppiB/ppiB and BpsWT strains. Using label

192 free based quantitative (LFQ) proteomics, we identified 2091 proteins with high

193 consistency observed across biological replicates as determined by Pearson on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209

194 correlations (average: 0.95, Supplementary Fig 4). Consistent with the role of PpiB in

195 multiple cellular pathways, 734 proteins underwent statistically significant alterations

196 within the proteome of BpsΔppiB compared to BpsWT (Supplementary Table 1) with

197 these proteins predicted to be localized to multiple cellular compartments (Fig 4A).

198 Consistent with the loss of PpiB in BpsΔppiB, this protein demonstrated the largest fold

199 difference of -10.14 log2 within the proteome with the majority of altered proteins also

200 showing a decreased abundance in response to loss of PpiB (Fig 4B). Upon

201 complementation, PpiB levels were restored to 10% of the level of wild-type, yet

202 consistent with phenotypic assays, this led to restoration of proteins observed to

203 increase (Fig 4C) and decrease (Fig 4D) to near wild-type levels. Within the categories

204 of proteins that had reduced abundance upon the loss of PpiB, we observed alterations

205 in multiple proteins associated with motility, consistent with the reductions in BpsΔppiB

206 including BPSL3305 (CheW, -2.78587 log2, -log10(P-value): 4.38) and BPSL3301

207 (CheB1, -2.48162 log2, -log10(P-value): 6.03) as well as the flagellin (BPSL3319, FliC -

10

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208 3.38141 log2, -log10(P-value): 5.81). Again, consistent with phenotypic assay

209 complementation only partial restoration of these proteins occurred with FliC only

210 restored by 0.9 log2. Other changes observed in response to the loss of PpiB including

211 reduction in capsule-associated proteins BSPL2799 (WcbI, -1.32 log2, -log10(P-value): http://iai.asm.org/ 212 4.30), BSPL2800 (WcbH, -0.47 log2, -log10(P-value): 1.36), BPSL2807 (WcbC, -0.36

213 log2, -log10(P-value): 1.61) (highlighted in green in Fig 4D) and BPSL2810 (ManC, 0.80

214 log2, -log10(P-value): 2.33), as well as increases in multiple components of the Type VI

215 T6SS-3 including BPSS2099 (TssC3, 4.49 log2, -log10(P-value): 3.38) and BPSS2098 on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 216 (Hcp3, 3.99 log2, -log10(P-value): 4.28) (highlighted in blue in Fig 4B). A KEGG

217 pathway analysis was undertaken to determine what functional pathways were being

218 affected in Bps∆ppiB (Fig 5). accounted for 268 of differentially present

219 proteins, with 170 being increased while 98 were decreased. Genetic Information

220 Processing, Signalling and Cellular Processes, and Environmental Information

221 Processing related proteins were a majority of proteins affected. In addition, many

222 hypothetical or unassigned proteins were also differentially present.

223

224 BpsΔppiB has decreased motility and biofilm formation under nutrient rich

225 conditions.

226 Motility of B. pseudomallei has been shown to be important for successful establishment

227 of in vitro and in vivo infections (15, 16). The motility of Bps∆ppiB was determined

228 using a swarming assay (Fig 6). The mean bacterial spread from the site of inoculation

229 of the BpsWT parental strain was 48.5 mm after 24 hours. In comparison the spread of

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Downloaded from 230 Bps∆ppiB was reduced to 24.5 mm (P-value 0.0022, Mann Whitney U-test), but was not

231 restored in the complemented strain, consistent with the partial restoration of motility

232 associated proteins levels as shown by the proteomics studies. This suggests a role for

233 PpiB in motility although further research is required to determine if this is a direct effect http://iai.asm.org/ 234 on the flagellum or due to regulatory or sensory deficits.

235

236 Another important survival mechanism in the environment and potentially for

237 establishing a chronic infection is the ability to form a biofilm. BpsΔppiB demonstrates on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209

238 significant attenuation in the formation of biofilms under nutrient rich conditions

239 compared to BpsWT (P-value 0.0022, Mann-Whitney U-test), again this was not

240 restored in the complemented strain (Fig 6B).

241

242 BpsΔppiB has greater susceptibility to antimicrobial and intracellular stresses.

243 The reduced survival of Bps∆ppiB under both in vitro and in vivo conditions may be a

244 consequence of incorrect folding of proteins involved in resistance to intracellular

245 stresses such as peroxide and acid tolerance. This was determined by minimum

246 inhibitory concentrations (MIC) of Bps∆ppiB to hydrogen peroxide and hydrochloric acid.

247 BpsΔppiB demonstrates greater sensitivity towards oxidative stress, with a significant 3-

248 fold reduction in the MIC of hydrogen peroxide exposure compared to BpsWT, which is

249 partially restored in Bps∆ppiB/ppiB (Fig 7). There was however, no increased

250 susceptibility to acid stress perhaps reflected in the ability of Bps∆ppiB to survive in

251 cells (Supplementary Table 2). 12

Downloaded from 252

253 B. pseudomallei is intrinsically resistant to antimicrobials which are cleared by active

254 efflux pumps (9). It is feasible that PpiB may be involved in protein folding of some efflux

255 pumps, as such the susceptibility to antimicrobials was investigated. In particular the http://iai.asm.org/ 256 MIC to antimicrobials that are currently used for B. pseudomallei treatment was

257 determined (Table 1). BpsΔppiB displayed a 4-fold increase in susceptibility (128

258 µg/mL to 8 µg/mL) to the 3rd-generation cephalosporin ceftriaxone. B. pseudomallei is

259 intrinsically resistant to 3rd-generation cephalosporins, indicating that some mechanism on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 260 of resistance is being modulated by PpiB. There was a 2-fold decrease in resistance to

261 tetracycline (2 µg/mL to 0.5 µg/mL) and its derivative doxycycline (1 µg/mL to <0.25

262 µg/mL). Tetracyclines are involved in protein synthesis inhibition and the main

263 mechanism of resistance in B. pseudomallei is efflux out of the cell, confirming a

264 potential role for ppiB in the correct folding of efflux pumps. The complemented strain,

265 Bps∆ppiB/ppiB, partially restores resistance to those of wild type levels.

266

267 Discussion 268 Previous work has demonstrated that cyclophilin B plays a role in modulating virulence

269 in a number of bacterial species resulting in attenuation in vivo (32, 33, 38, 39).

270 Consistent with these studies we demonstrate that Cyclophilin B in B. pseudomallei

271 influences multiple virulence associated phenotypes with loss of the ppiB gene resulting

272 in complete attenuation in the BALB/c mouse infection model (Fig 2). Although most

273 work has focused on the role of cyclophilins in virulence, recently the direct interaction

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Downloaded from 274 of cyclophilin B with intracellular proteins important for bacterial growth and survival

275 such as DnaK, AccC and FtsZ has been reported (34, 35, 39-41). It is shown here that

276 B. pseudomallei deletion of ppiB leads to pleiotropic effects including stress intolerance,

277 reduction in motility and biofilm formation. Furthermore, the direct effect of ppiB loss on http://iai.asm.org/ 278 the proteome homeostasis of B. pseudomallei has been defined. Key pathways

279 important for virulence modulation have been identified and disrupted, providing

280 evidence of the importance of PpiB in bacterial protein folding and overall virulence.

281 on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209

282 B. pseudomallei is able to infect a wide range of cells in order to survive and cause

283 disease (42). Infection of murine macrophages demonstrated that BpsΔppiB retained its

284 ability to adhere and invade macrophage cells with reduced survival 6 and 9 hours post

285 infection (Fig 1), with intracellular counts similar to the parental control reached by 12

286 hours. This delayed growth phenotype has been shown with the disruption of type VI/III

287 secretion systems and is important in cell-to-cell spread of B. pseudomallei (27, 43, 44).

288 BpsΔppiB is unable to effectively spread intracellularly as determined by

289 immunofluorescence and cause cell fusion into MNGC, with complementation studies

290 showing restoration of the BpsWT phenotype (Fig 3B). As seen 12 hours post-infection

291 BpsWT and the complemented strain BpsΔppiB/ppiB display marked bacterial

292 movement throughout the monolayer and cellular fusion into MNGC (Fig 3A and 3C).

293 Enumeration of nuclei also indicates a significant reduction in the formation of MNGC in

294 BpsΔppiB, which is restored in the complement BpsΔppiB/ppiB (Fig 3D).

295 Complementation is observed despite only a 10% restoration of PpiB protein levels,

296 demonstrating that even low levels of PpiB is sufficient to overcome some virulence 14

Downloaded from 297 deficiencies, something which has been previously noted in Saccharomyces cerevisiae

298 (45). This lack of cell-to-cell spread is characteristic of various mutants of the T6SS

299 cluster-1 (26, 27, 46), in particular T6SS Cluster 1 mutants ∆hcp1 and ∆vgrG1 (26, 27).

300 It is hypothesized that PpiB is playing a role in either folding or regulating the expression http://iai.asm.org/ 301 of Type VI Secretion Systems in B. pseudomallei. It is reported that T6SSs in B.

302 pseudomallei are kept under strict transcriptional control and are only induced upon

303 invasion of macrophages (24), yet despite this our proteomic data showed an increase

304 in BPSS2098 (Hcp-1, 1.10 log2, -log10(P-value): 3.05) and BPSS2099 (Tss-1, 4.06 log2, on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 305 -log10(P-value): 1.8), two proteins belonging to T6SS-3, a cluster which is usually not

306 expressed in nutrient media (27, 47). Interestingly BPSL3097 (-1.28 log2, -log10(P-

307 value): 6.12), BPSL3099 (-0.87 log2, -log10(P-value): 2.89), BPSL3105 (-0.75 log2, -

308 log10(P-value): 3.31), BPSL3106 (-0.51 log2, -log10(P-value): 2.45) and BPSl3108 (-

309 0.82 log2, -log10(P-value): 4.37) were all decreased in BpsΔppiB. These belong to

310 T6SS Cluster 6 which has been shown to be the only T6SS expressed in nutrient media

311 (27). This again points to a dysregulation of transcriptional or translational control.

312 Additionally, a MarR-family regulator (BPSL3431) shown to be involved in regulation of

313 T6SS transcription was downregulated (-0.67 log2, -log10(P-value): 3.40) (48). This

314 indicates that T6SS proteins are escaping their tight transcriptional control in nutrient

315 media, and it is hypothesized the same is occurring upon infection in cells resulting in a

316 malfunctional T6SS and hence the loss of MNGC formation. Further assessment of the

317 transcriptome and proteome of BpsΔppiB upon invasion of macrophages would be

318 useful to verify if PpiB is playing a role at the transcriptional or translational level of

319 T6SS regulators or machinery. This also explains the clearance of infection in the

15

Downloaded from 320 BALB/c mouse studies where no viable bacteria were recovered at the end of the

321 experiment demonstrating the essential role of PpiB and its potential as a novel anti-

322 virulence target.

323 http://iai.asm.org/

324 Motility and biofilm formation are important for establishing B. pseudomallei infection

325 (13, 15). Deletion of the flagellum, ΔfliC, has been shown to be important for virulence in

326 the BALB/c mouse infection model (15, 49). Here a decrease in the protein levels of

327 FliC (BPSL3319, -3.38 log2, -log10(P-value): 5.81) is observed, consistent with the on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209

328 reduction in motility in BpsppiB with recent studies have demonstrated that PpiB from

329 Clostridioides difficle interacts with FliC using bacterial two-hybrid systems (50).

330 Furthermore, reduced levels of CheB1 (BPSL3301, -2.48 log2, -log10(P-value): 6.02)

331 and CheW (BPSL3305, -2.78 log2, -log10(P-value): 4.38) (Fig 6B), important for

332 chemotactic directed motility (51-54), may also contribute to the observed reduction in

333 motility. As BpsΔppiB only displayed a decrease in motility, not a complete loss, there is

334 potentially a dysregulation of the signal transduction pathways leading to a delay or

335 absence of appropriate signalling to begin movement, rather than elimination of the

336 flagellum in BpsΔppiB, although additional studies are required to validate this. Motility

337 has also been implicated as an important factor for biofilm production with ΔfliC mutants

338 showing a decrease in biofilm production (55). Transcriptomics have identified B.

339 pseudomallei genes important in biofilm formation (56) and of these genes flagged as

340 differentially regulated, 12 were present at opposing protein abundance in BpsΔppiB

341 possibly explaining the decrease in biofilm formation by BpsΔppiB (Fig 6B), with genes

16

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342 such as universal stress proteins (BPSS0837, -1.16 log2, -log10(P-value): 4.66;

343 BPSS1140, -0.57 log2, -log10(P-value): 2.03), receptors (BPSS1742, -1.22 log2, -

344 log10(P-value): 4.10) and efflux pumps (BPSL0816, 0.35 log2, -log10(P-value): 2.13)

345 being differentially expressed. This decrease in biofilm formation is in stark contrast to http://iai.asm.org/ 346 what has been reported in E. coli where PpiB is a negative regulator of both biofilm and

347 motility with deletion of ppiB resulting in hypermotility and increased biofilm production

348 (34). This disparity may indicate different roles for PpiB in E. coli and B. pseudomallei,

349 but a lack of in vivo data with ΔppiB makes it difficult to determine the overall effect on on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 350 virulence.

351

352 Cyclophilin B in Gram-negatives are known to play a role in response to a variety of

353 stresses encountered during infection (32). B. pseudomallei is exposed to reactive

354 oxidising species within phagocytes, a natural defence mechanism for eukaryotic cells

355 (57), with loss of ppiB increasing the susceptibility to oxidative stress (Fig 7). Others

356 have shown that there are a variety of mechanisms by which B. pseudomallei responds

357 to and tolerates oxidative stress, with quorum sensing regulating of

358 genes important in protecting the cell against DNA damage as well as polyphosphate

359 kinases playing a role (55, 58, 59). Although none of these genes appear in the

360 proteomics screen, proteins involved in stress (BPSS0837 -1.3 log2, -log10(P-value):

361 3.63, BPSS1140 -0.57 log2, -log10(P-value): 2.03) and OmpR, an oxidative stress two-

362 component system transcriptional regulator (BPSL2094, -0.53 log2, -log10(P-value):

363 2.69), are decreased and may play an as of yet unknown role in oxidative stress

17

Downloaded from 364 response. These results indicate that other currently unknown mechanisms may exist to

365 combat oxidative stress and this warrants further investigation.

366

367 B. pseudomallei has a number of chromosomally encoded genes associated with http://iai.asm.org/

368 antimicrobial resistance and hence is intrinsically resistant to most antibiotics used to

369 treat serious infections (9). BpsΔppiB has increased susceptibility to ceftriaxone,

370 tetracycline and doxycycline, antibiotics currently used for treatment of melioidosis

371 (Table 1) (7, 8). Resistance to these antibiotics is shown to be moderated by on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209

372 Resistance-Nodulation Division (RND) efflux pumps (60), of which B. pseudomallei

373 strain K96243 has 10 annotated within its genome, as well as by beta-lactamases (9,

374 61). Differences in the protein levels of the efflux pump components, AmrA (BPSL1804,

375 -1.66 log2, -log10(P-value): 2.98), BpeB (BPSL0815 0.2 log2, -log10(P-value): 1.97) and

376 OprB (BPSL2094, -0.53, -log10(P-value): 2.69), indicate that loss of PpiB may result in

377 malfunctioning pumps. It is hypothesized that deletion of ppiB results in a reduction of

378 the pump components, making ineffective pumps and restoring susceptibility to certain

379 antibiotics.

380

381 There are many reports on the pleiotropic effects that immunophilin proteins have in

382 cells, this study demonstrates that virtually every compartment within the cell displays

383 gross proteomic changes, especially those involved in metabolism and genetic

384 information processing (32, 34, 38, 50, 62). It has recently been shown by Rasch et al

385 (38) that proteins from the immunophilin family also have the ability to compensate one

18

Downloaded from 386 another, in this case the macrophage infectivity potentiator (Mip) protein, belonging to

387 the FK506-binding protein family, is able to compensate for the loss of PpiB in L.

388 pneumophila (38). This compensatory effect has always been theorised, these studies

389 show that there is an increase in the protein levels of three immunophilin proteins, Mip http://iai.asm.org/ 390 (BPSS1823, 0.98 log2, -log10(P-value): 2.42), PpiA (BPSL2245, 1.1 log2, -log10(P-

391 value): 3.05) and SurA (BPSL0659, 0.53 log2, -log10(P-value): 2.53), whether these

392 proteins can compensate and to what degree for PpiB loss in B. pseudomallei requires

393 further investigation. on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 394

395 To conclude, PpiB in B. pseudomallei is essential for virulence with the deletion mutant

396 BpsΔppiB displaying pleiotropic effects on virulence determinants such as the flagella,

397 biofilm production and antimicrobial susceptibility. Infection of macrophages with

398 BpsΔppiB displayed a delayed growth phenotype and an inability to cause fulminant

399 disease in BALB/c mice. On closer investigation it was shown that this was due to

400 BpsΔppiB being unable to spread cell-to-cell and form MNGCs, indicating that

401 clearance of infection occurs in vivo. Whole cell proteomic analysis reveals marked

402 changes in the proteome including proteins previously shown to be important for cell-to-

403 cell spread and virulence of B. pseudomallei and has also identified a plethora of new

404 proteins potentially playing an important role in infection. Although further work still

405 needs to be conducted to demonstrate the direct interactions of PpiB with its folding

406 partners, it is clear that PpiB is essential for the correct protein folding of virulence

407 determinants in B. pseudomallei, thus making it indispensable for virulence.

19

Downloaded from 408

409 Materials and methods

410 Bacterial strains and growth conditions. The bacterial strains used in this study are

411 shown in Table 2. All bacterial strains were grown in Luria Bertani (LB) broth overnight http://iai.asm.org/

412 at 37°C with agitation unless stated otherwise. Antibiotics were used at final

413 concentrations of: ampicillin, 50 µg/ml; chloramphenicol, 30 µg/ml; kanamycin, 50 µg/ml.

414 on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 415 Construction of in-frame deletion mutant of ppiB. Construction of B. pseudomallei

416 in-frame deletion mutants was performed using the technique previously described by

417 Logue et al (37). For ppiB a 449-bp upstream flanking region and a 403-bp downstream

418 flanking region were amplified by Polymerase Chain Reaction (PCR) from B.

419 pseudomallei K96243 genomic DNA (obtained using Qiagen Gentra Purgene

420 Yeast/Bact Kit) using the primer pairs ppiB_UP_F/ppiB_UP_R

421 (TCTAGATTCCATCGCGTGATCAAGGG/ AGATCTTGGTTCCTTCGATGGATGGG)

422 and ppiB_DN_F/ppiB_DN_R (AGATCTGGGATGTTGCAGGAGACACC/

423 TCTAGATTGCCGAACGCGACGATG). Restriction sites were incorporated into the

424 primers to allow for the ligation of the flanks to one another (using BglII) and XbaI to

425 allow for the insertion of the joint flanks into the suicide plasmid, pDM4. Upon

426 construction of an upstream-downstream fragment and its subsequent ligation into

427 pDM4, the construct was transformed by heat shock into E. coli S17-1 λpir which were

428 made calcium competent, and selected for with the antibiotic chloramphenicol.

429 Following conjugation with B. pseudomallei K96243, merodiploid integrants that has

20

Downloaded from 430 successfully integrated the upstream-downstream-pDM4 construct were identified using

431 double antibiotic selection of ampicillin/chloramphenicol. A merodiploid integrant was

432 plated onto LB agar lacking sodium chloride but containing 10 % sucrose. sacB counter-

433 selection was used to select for the excision of the pDM4 backbone, resulting in an in- http://iai.asm.org/ 434 frame unmarked deletion. Colonies were subsequently screened for chloramphenicol

435 sensitivity and analysed by PCR to determine their phenotype; wild-type revertant or in-

436 frame deletion mutant. Colonies determined to be in-frame deletion mutants had the site

437 of recombination sequenced (Sanger sequencing) to confirm a 492-bp deletion of ppiB. on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 438 The mutant strain, B. pseudomallei∆ppiB (BpsΔppiB) and the parent B. pseudomallei

439 K96243 strain was sequenced using Illumina MiSeq (Murdoch University, Perth,

440 Western Australia) or HiSeq2500 (Australian Genome Research Facility, Melbourne,

441 Australia) respectively. Whole genome sequencing data was aligned to the K96243

442 reference genome (versions NC_006350.1 [ 1] and NC_006350.1

443 [chromosome 2]) and variants were identified using the SPANDx pipeline (62).

444

445 J774A.1 murine macrophage infection assay. J774A.1 murine macrophages were

446 seeded into a 24-well tissue culture treated plate at a concentration of 4 x 105 cells/mL

447 in Dulbecco’s modified eagle’s medium (DMEM) (Gibco) supplemented with a final

448 concentration of 1 % GlutaMAX (Gibco, Life Technologies) and 10 % heat-inactivated

449 fetal calf serum (Gibco, Life Technologies, Lot #1939338) and incubated for 20 hours at

450 37°C with 5 % CO2. B. pseudomallei strains were grown overnight at 37°C for 18 hrs

451 and adjusted in Leibovitz L-15 medium (Gibco) supplemented with 1 % GlutaMAX and

452 10 % heat-inactivated fetal calf serum to an absorbance between 0.35 and 0.4 at 580 21

Downloaded from 453 nm using a PLP Colourimeter. Strains were serially diluted in L-15 medium and 1 mL of

454 bacteria was added to each well at a multiplicity of infection (MOI) of 10 and incubated

455 30 minutes at 37°C. To determine the exact starting inoculum at time of infection

456 bacteria were further serially diluted and plated on LB agar. Bacteria were aspirated off http://iai.asm.org/ 457 the cell monolayer and infected cells were gently washed three times with PBS (Life

458 Technologies, autoclaved and filter sterilised) and then incubated with L-15 medium

459 containing 1 mg/mL kanamycin for a further 30 minutes at 37°C to kill extracellular

460 bacteria. The supernatant was removed and infected cells were then incubated with L- on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 461 15 media containing 250 µg/mL kanamycin for 12 hours. At 0, 3, 6, 9 and 12 hours post-

462 infection, cell monolayers were lysed with 1 mL MilliQ water and serially diluted in 1 mL

463 PBS and plated onto LB agar for bacterial enumeration.

464

465 Determination of Minimum Inhibitory Concentration (MIC) and susceptibility to

466 stress. Broth microdilutions were tested against a variety of antibiotic classes as

467 described in (63) with the following modifications. Strains were incubated overnight in

468 Mueller Hinton Broth (MHB) at 37°C. Overnight cultures were diluted 1:50 in fresh MHB

469 and were incubated at 37°C for 1 hour with agitation. Antibiotics were 2-fold serially

470 diluted across a 96-well plate in MHB with a final volume of 100 µL with an antibiotic

471 range of 256 to 0.25 μg/mL. Following bacterial incubation, 100 µL of each strain was

472 added to antibiotic containing media in a 96 well plate and incubated statically at 37°C

473 for 24 hours. Optical density of plates was read at an optical density of 590 nm using a

474 spectrophotometer (BioRad Xmark). The Minimum Inhibitory Concentration (MIC) was

22

Downloaded from 475 called as the minimum antibiotic concentration needed to keep overnight growth to

476 under 20% of the unexposed bacterial growth control.

477

478 Motility assay. Assessment of motility was performed as described in (64). Briefly, B. http://iai.asm.org/

479 pseudomallei strains were incubated at 37°C overnight with agitation. One microliter of

480 overnight culture was stabbed into the middle of a 0.3 % motility agar using a sterile

481 inoculation loop and plates were incubated upright for 24 hours upon which the distance

482 of bacterial spread was measured. on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209

483

484 Biofilm Forming Capacity Assay. Biofilm assays were performed according following

485 the methodology in (65) but with the following modifications. B. pseudomallei strains

486 were incubated overnight at 37°C with agitation. The following day 2% of overnight

487 culture (v/v) was inoculated into fresh media and incubated for a further 24 hours at

488 37°C with agitation. Overnight cultures (200µL) were added to a 96-well plate and

489 incubated for 3 hours at 37°C to allow for adhesion. Supernatant was gently aspirated to

490 avoid disturbing the adhered cells and fresh Luria Bertani Broth was added and

491 incubated at 37°C for a further 24 hours. Supernatant was aspirated and biofilms were

492 washed once with PBS and fresh LBB media added and incubated for a further 24

493 hours. On the final day supernatant was removed and biofilms were washed three times

494 with PBS before being fixed with methanol and allowed to air dry. Cells were stained

495 with 2 % crystal violet, with excess stain removed with running ddH2O and plates were

23

Downloaded from 496 allowed to air dry. Dye bound to cells was solubilised with 33 % Glacial acetic acid and

497 the optical density was read at 590 nm on a spectrophotometer (BioRad X-Mark).

498

499 BALB/c murine infection model http://iai.asm.org/

500 Investigations involving animals were carried out according to the requirements of the

501 United Kingdom Animal (Scientific Procedures) Act 1986 under project licence PPL

502 30/3026. This project licence was approved following an ethical review by Dstl's Animal

503 Welfare and Ethical Review Body. Studies were performed using female BALB/cAnNCrl on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209

504 mice (BALB/c; Charles River, UK) implanted with a subcutaneous Pico transponder

505 (Uno BV, Netherlands) to allow individual mice to be tracked through the study. On

506 arrival into containment level 3 animal facilities, mice were randomly allocated into

507 cages of five animals and acclimatised to their new surroundings for 5 days before any

508 procedures were performed. Animal husbandry practices and environmental conditions

509 during study were as described previously Scott et al (66). Challenges were performed

510 with B. pseudomallei K96243 prepared as described previously by Scott et al (66) and

511 delivered via the intraperitoneal route. Mice received 1.1 x 104 CFU B. pseudomallei

512 K96243 and 1.86 104 CFU Bps∆ppiB, 6 in each group. Mice were checked at least twice

513 daily following challenge and clinical signs for each mouse recorded for five weeks post‐

514 infection. Humane end‐points were used throughout these studies to minimise suffering,

515 with culls performed via cervical dislocation at the end‐point. At the end of the study,

516 animals were culled and organs removed for enumeration of bacterial burden (lungs,

24

Downloaded from 517 liver, spleen). These were homogenised through 40 μm sieves into PBS, serially diluted

518 and plated onto LB agar.

519

520 Complementation studies. http://iai.asm.org/

521 The open reading frame of BPSL2246 (ppiB) was amplified from genomic DNA of B.

522 pseudomallei K96243 using the primers ppiB_For/ppiB_Rev

523 (CTGCAGATGGTCGAACTGCATACG/CTGCAGGGACCACGACGGCCTTCT) and the

524 resulting product was ligated into pJR3XFLAG that incorporated a 3XFLAG tag on the on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209

525 C-terminal end of the gene. This was then amplified with the primers

526 ppiB_pET_For/BamHI_stop_FLAG_Rev

527 (CATATGGTCGAACTGCATACGAAC/GGATCCTTACTTGTCATCGTCATCCTTAT).

528 The PCR product was inserted into the SmaI/BamHI restriction sites of pBBR1-MCS1.

529 The complementation construct was transformed into E. coli ST18 and conjugated into

530 Bps∆ppiB. Conjugates were selected on LB agar containing 30 μg/mL chloramphenicol.

531 In experiments the complemented mutant strain (Bps∆ppiB/ppiB) was grown in LB broth

532 containing 30 μg/mL chloramphenicol.

533

534 Immunofluorescence. J774A.1 macrophages (seeded at approximately 4 x 105

535 cells/well) were grown overnight on 13 mm round coverslips in a 24 well plate at 37°C

536 with 5% CO2. Macrophages were infected with B. pseudomallei strains at an MOI of 10

537 as described above in the J774.A1 murine macrophage infection assay. At 12 hours

538 post infection monolayers were washed 3 times with PBS for 5 minutes and fixed with 25

Downloaded from 539 100 % methanol for 30 minutes, then washed 3 times with PBS for 5 minutes.

540 Monolayers were stained at room temperature using the following protocol. Monolayers

541 were blocked with 5 % (v/v) FCS/PBS for 2 hours to block non-specific binding and then

542 washed 3 times for 2 minutes each. Cells were incubated with anti-B. pseudomallei-LPS http://iai.asm.org/ 543 at 1 µg/mL (1:100; Mab4VIH12) for 1 hour, after which they underwent 3 times 2

544 minutes washes. Monolayers were incubated with a secondary Anti-mouse-whole IgG-

545 FITC (1:64; Sigma Aldrich) for 1 hour followed by three times 2-minute washes. Nuclei

546 were stained using Hoescht33258 (1:10,000; ThermoFisher Scientific) for 15 minutes on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 547 followed by 2 x 2 minute washes. Coverslips were mounted onto glass slides using

548 Prolong Gold Anti-Fade reagent (Invitrogen). Fluorescence microscopy was performed

549 using a Nikon Eclipse Ts2R microscope and images were acquired using the NIS-

550 Elements software (Nikon).

551

552 Multinucleated Giant Cell enumeration (MNGC). Evaluation of MNCG formation was

553 conducted using fluorescently stained cell monolayers described above. Using

554 previously published metrics (67); 1000 nuclei per coverslip were counted and the

555 percentage of MNGC formation was calculated using the following equation;

number of nuclei within multinucleated cells MNGC (%)= X 100 total nuclei counted

556

557 Protein clean up and In-solution digestion. Cell preparations were solubilized in lysis

558 buffer (4 % SDS, 10 mM DTT, 100 mM Tris pH 8.5) by boiling for 10 minutes and the

26

Downloaded from 559 protein content assess by BCA protein assay according to the manufacturer's

560 instruction. 100 ug of protein from each sample was acetone precipitated by mixing 4

561 volumes of ice-cold acetone with one volume of sample. Samples were precipitated

562 overnight at -20°C and then spun down at 4000 x g for 10 minutes at 4°C. The http://iai.asm.org/ 563 precipitated protein pellets were resuspended with 80 % ice-cold acetone and

564 precipitated for an additional 4 hours at -20°C. Samples were spun down at 17000 x g

565 for 10 minutes at 4°C to collect precipitated protein, the supernatant was discarded and

566 excess acetone driven off at 65°C for 5 minutes. Dried protein pellets were resuspended on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 567 in 6 M urea, 2 M thiourea, 40 mM NH4HCO3 and reduced / alkylated prior to digestion

568 with Lys-C (1/200 w/w) then trypsin (1/50 w/w) overnight as previously described (68).

569 Digested samples were acidified to a final concentration of 0.5 % formic acid, desalted

570 with homemade C18 stage tips (69, 70), eluted with buffer B (80 % ACN, 0.1 % formic

571 acid) and bound peptides eluted with buffer B then dried.

572

573 LFQ based quantitative proteome LC-MS. Purified peptides were resuspended in

574 Buffer A* and separated using a two-column chromatography set up comprising a

575 PepMap100 C18 20 mm x 75 μm trap and a PepMap C18 500 mm x 75 μm analytical

576 column (ThermoFisher Scientific). Samples were concentrated onto the trap column at 5

577 μl/min for 5 mins and infused into an Orbitrap Elite™ Mass Spectrometer (ThermoFisher

578 Scientific) at 300 nl/min via the analytical column using a Dionex Ultimate 3000 UPLC

579 (ThermoFisher Scientific). 90 min gradients were run altering the buffer composition

580 from 1 % buffer B to 28 % B over 60 mins, then from 28 % B to 40 % B over 10 mins,

581 then from 40 % B to 100 % B over 2 mins, the composition was held at 100 % B for 3

27

Downloaded from 582 mins, and then dropped to 3 % B over 5 mins and held at 3 % B for another 10 mins.

583 The Elite™ Mass Spectrometer was operated in a data-dependent mode automatically

584 switching between the acquisition of a single Orbitrap MS scan (120,000 resolution)

585 followed by 20 data-dependent CID MS-MS events (NCE 35) were allowed with 30 http://iai.asm.org/ 586 seconds dynamic exclusion enabled.

587

588 Mass spectrometry data analysis. Identification of proteins was accomplished using

589 MaxQuant (v1.5.3.1) (71). Searches were performed against the Burkholderia on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 590 pseudomallei strain K96243 (Uniprot proteome id UP000000605, downloaded 10-07-

591 2018, 5,717 entries) proteomes with carbamidomethylation of cysteine set as a fixed

592 modification. Searches were performed with trypsin cleavage specificity allowing 2

593 miscleavage events and the variable modifications of oxidation of methionine and

594 acetylation of protein N-termini. The precursor mass tolerance was set to 20 parts-per-

595 million (ppm) for the first search and 10 ppm for the main search, with a maximum false

596 discovery rate (FDR) of 1.0 % set for protein and peptide identifications. To enhance the

597 identification of peptides between samples the Match Between Runs option was

598 enabled with a precursor match window set to 2 minutes and an alignment window of 10

599 minutes. For label-free quantitation, the MaxLFQ option within Maxquant (72) was

600 enabled in addition to the re-quantification module. The resulting protein group output

601 was processed within the Perseus (v1.4.0.6) (73) analysis environment to remove

602 reverse matches and common protein contaminates prior. GO terms and associated

603 annotation was downloaded from Uniprot (Uniprot proteome id UP000000605,

604 downloaded 10-07-2018). For LFQ comparisons missing values were imputed using

28

Downloaded from 605 Perseus and Pearson correlations visualized using Perseus and R. Determination of

606 significant changes was undertaken using a two-sample t-test within Perseus where

607 proteins were considered significant if the mean difference between groups was great

608 then or less than one-fold change and satisfied a Benjamini-Hochberg multiple http://iai.asm.org/ 609 hypothesis corrected FDR of below 0.05 which corresponds to a -log10(P-value) of 1.73

610 or p-value of 0.018. The mass spectrometry proteomics data have been deposited to

611 the ProteomeXchange Consortium via the PRIDE (74) partner repository with the

612 dataset identifier PXD012956. on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 613

614 Statistical Analysis. All numerical results were analysed using Microsoft Excel 2010.

615 Statistical analyses performed using GraphPad Prism version 8.0. For growth curves,

616 motility, biofilm, MIC, intracellular infection and cell cytotoxicity assays, a Mann-Whitney

617 U-test was used to determine the difference between strains. The Log-rank (Mantel-

618 Cox) test was used for the animal studies. A Student’s t-test was used for MNGC

619 formation. Significance is indicated as follows: *, P-value <0.05; **, P-value <0.01; ****,

620 P-value <0.0001.

621

622 Acknowledgements

623 NB was supported by an Australian Government Research Training Program

624 Scholarship. MST and TJJI were funded by NATO (SPF984835). This work was

625 partially supported by National Health and Medical Research Council of Australia

626 (NHMRC) project grants awarded to NES (APP1100164). We would like to thank the

29

Downloaded from 627 Melbourne Mass Spectrometry and Proteomics Facility of The Bio21 Molecular Science

628 and Biotechnology Institute at The University of Melbourne for support, maintenance

629 and access to mass spectrometry infrastructure for proteomic analysis. We would like to

630 thank Dr Nathan Pavlos for providing an aliquot of Hoecsht33258 to use for the http://iai.asm.org/ 631 immunofluorescence studies. We would also like to thank Dr Joshua Ramsay for

632 providing ST18 strain of E. coli used in conjugation as well as the plasmid pJR3XFLAG

633 to help with the construction of the complementation strain.

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864 chromatography and parallel fragmentation by CID, higher energy collisional

865 dissociation, and electron transfer dissociation MS applied to the N-linked

866 glycoproteome of Campylobacter jejuni. Mol Cell Proteomics 10:M000031-

867 MCP201.

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870 proteomics. J Proteome Res 5:988-94.

871 70. Rappsilber J, Mann M, Ishihama Y. 2007. Protocol for micro-purification, http://iai.asm.org/ 872 enrichment, pre-fractionation and storage of peptides for proteomics using

873 StageTips. Nat Protoc 2:1896-906.

874 71. Cox J, Mann M. 2008. MaxQuant enables high peptide identification rates,

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877 72. Cox J, Hein MY, Luber CA, Paron I, Nagaraj N, Mann M. 2014. Accurate

878 proteome-wide label-free quantification by delayed normalization and maximal

879 peptide ratio extraction, termed MaxLFQ. Mol Cell Proteomics 13:2513-26.

880 73. Tyanova S, Temu T, Sinitcyn P, Carlson A, Hein MY, Geiger T, Mann M, Cox J.

881 2016. The Perseus computational platform for comprehensive analysis of

882 (prote)omics data. Nat Methods 13:731-40.

883 74. Perez-Riverol Y, Csordas A, Bai J, Bernal-Llinares M, Hewapathirana S, Kundu

884 DJ, Inuganti A, Griss J, Mayer G, Eisenacher M, Perez E, Uszkoreit J, Pfeuffer J,

885 Sachsenberg T, Yilmaz S, Tiwary S, Cox J, Audain E, Walzer M, Jarnuczak AF,

886 Ternent T, Brazma A, Vizcaino JA. 2019. The PRIDE database and related tools

887 and resources in 2019: improving support for quantification data. Nucleic Acids

888 Res 47:D442-D450.

889 75. Penfold RJ, Pemberton JM. 1992. An improved suicide vector for construction of

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892 diparental mating. FEMS Microbiol Lett 294:127-32.

893

894 Figures http://iai.asm.org/

895 Figure 1. BpsΔppiB shows reduced intracellular survival in J774.A1 murine

896 macrophages. (A) Intracellular growth of BpsWT (●) and BpsΔppiB () in J774A.1

897 murine macrophages was infected at an MOI of 10 and intracellular counts taken at 0,

898 3, 6, 9 and 12. Graphs are the mean of five biological replicates with each having two on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209

899 technical replicates. The error bars displaying the Standard Error of the Mean. * P-value

900 of 0.0159 by Mann-Whitney U-test.

901

902 Figure 2. BpsΔppiB is attenuated in the BALB/c mouse model of infection. (A)

4 903 BALB/c mice (n=6) were injected intraperitoneally with 1.1 x 10 CFU BpsWT (●) and

4 904 1.86 X 10 CFU of Bps∆ppiB (▲). * P-value 0.0183 by Log-rank test. Weight loss of

905 individual BALB/c mice (labelled 1 – 6) was monitored daily following intraperitoneal

906 infection as a measure of morbidity in (B) B.psWT and (C) B.psΔppiB.

907 908 Figure 3. BpsΔppiB demonstrates reduced formation of multinucleated giant cells

909 in J774 murine macrophages. Fluorescently stained monolayers infected with either

910 (A) BpsWT, (B) BpsΔppiB or (C) BpsΔppiB/ppiB. were stained with Anti-Bps-LPS-FITC

911 and nuclei are stained with Hoescht33258, bar indicates 14µM. (D) Percentage of nuclei

912 associated with a MNGC, BpsWT (●), BpsΔppiB () and BpsΔppiB/ppiB (■). Graphs

42

Downloaded from 913 are the result of three biological repeats with each biological repeat containing two

914 technical repeats. 1000 nuclei were counted from each coverslip with them either being

915 part of a multinucleated cell or mononucleated and then the percentage of

916 multinucleated was calculated. * P-value 0.026 and ** P-value 0.0022 by Mann-Whitney http://iai.asm.org/ 917 U-test.

918 919 Figure 4. Quantitative proteomic analysis of BpsWT vs BpsΔppiB. Label-free

920 quantification was undertaken to compare BpsΔppiB to BpsWT. A) Identified proteins on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 921 are presented as a volcano plot depicting mean label free quantitation (LFQ) intensity

922 ratios of BpsΔppiB versus BpsWT plotted against logarithmic t test p values from four

923 biological experiments of each strain. B) GO terms assigned localization of the 42 out

924 the 213 proteins which undergo statistically significant changes with localization

925 assignment. Only GO localization terms for groups with greater than 3 entries are

926 shown. Complementation of PpiB lead to restoration of proteins observed to (C)

927 increase and (D) decrease to near BpsWT levels.

928

929 Figure 5. KEGG Pathway analysis of proteins differentially present in BpsWT vs

930 BpsΔppiB. Proteins that were differentially present by proteomics (Supplementary

931 Table 1) were manually curated using the Kyoto Encyclopaedia of Genes and Genomes

932 (KEGG) database against the Burkholderia pseudomallei K96243 genome (entry

933 number T00203) and assigned a KEGG Orthology (KO). Proteins in red were increased

934 in BpsΔppiB relative to BpsWT, while proteins in blue were decreased. Numerous

43

Downloaded from 935 proteins were predicted to be in other functional groups but only the highest KO was

936 taken down.

937 938 Figure 6. BpsΔppiB has significantly reduced motility and biofilm formation. (A) http://iai.asm.org/ 939 Swarming motility of BpsWT (●), BpsΔppiB () and BpsΔppiB/ppiB (■) through 0.3 %

940 agarose plates. Values are the diameter of spread with readings taken at 24 hours post-

941 inoculation. Results are of three biological replicates. ** P-value 0.0022 by Mann

942 Whitney U-test. (B) Biofilm forming capacity of BpsWT (●), BpsΔppiB () and on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 943 BpsΔppiB/ppiB (■) in nutrient LB broth. Biofilms were allowed to form over a 48 hour

944 period before being fixed with methanol and stained with crystal violet to determine

945 bacterial biomass. Crystal violet was solubilised with 33 % glacial acetic acid and optical

946 density was read with a spectrophotometer (BioRad Xmark) at 590 nm. Bars are

947 representative of the mean optical density with individual values plotted. Six biological

948 replicates with 6 technical repeats were conducted. ** P-value by Mann-Whitney U-test.

949 950 Figure 7. BpsΔppiB demonstrates greater sensitivity towards oxidative stress.

951 Survival of BpsWT (●), BpsΔppiB () and BpsΔppiB/ppiB (■) in increasing

952 concentrations of hydrogen peroxide. Values are the mean MIC of three biological

953 replicates. Concentrations are in µL/mL of 30% Hydrogen Peroxide (BioVar) solution.

954 MIC was determined by measuring the optical density (OD 590 nm) at 24 hours post

955 hydrogen peroxide exposure and MIC was called as the lowest concentration which

956 resulted in less than 20 % growth (dotted line) of the unexposed control on that plate.

44

Downloaded from 957

Antibiotic BpsWT BpsΔppiB BpsΔppiB/ppiB

Ceftriaxone 128 8 16

Meropenem 2 0.5 1

Tetracycline 2 0.5 1 http://iai.asm.org/

Doxycycline 1 <0.25 0.5

958 959 Table 1. Minimum Inhibitory Concentration (MIC) as determined by broth

960 microdilutions. Values are the mean MIC of three biological replicates. Concentrations on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209

961 are in µg/mL for antibiotics. MIC was determined by measuring the optical density (OD

962 590 nm) at 24 hours post antibiotic exposure and MIC was called as the lowest

963 concentration which resulted in less than 20 % growth of the unexposed control on that

964 plate.

965

966

967

968

969

970

971

972

973

Strain or plasmid Genotype or description Source or

45

Downloaded from reference

Escherichia coli

TOP10® Chemically competent cloning strain Invitrogen

S17-1 λpir S17-1 with a λ prophage carrying the pir gene, (75)

conjugal strain for the movement of pDM4 http://iai.asm.org/

ST18 S17-1 λpirΔhemA, conjugal strain for the (76)

movement of pBBR1-MCS1

Burkholderia pseudomallei

K96243 (WT) Clinical isolate Dstl, (61) on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 ∆ppiB K96243 derivative; unmarked deletion ∆ppiB This study

∆ppiB/ppiB K96243 derivative; unmarked deletion ∆ppiB; This study

ppiB_3XFLAG_pBBR1-MCS1

974

975 Table 2. Bacterial strains and plasmids used in this study

46

Downloaded from http://iai.asm.org/ on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 Downloaded from A

*

http://iai.asm.org/

B 22 1 on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 20 2 18 3 4 16 5

Weight (g) 14 6 12

-5 0 5 10 15 20 25 30 35 Days post challenge

C 22 1 20 2 18 3 4 16 5

Weight (g) 14 6 12

-5 0 5 10 15 20 25 30 35 Days post challenge Downloaded from http://iai.asm.org/ on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 A B Downloaded from

http://iai.asm.org/

C D

on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209

Downloaded from http://iai.asm.org/ on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209

Downloaded from

Hypothetical Protein Unassigned Not Included in Pathway Cellular Processes Human Disease Genetic Information Processing

Signalling and Cellular Processes http://iai.asm.org/ Environmental Information Processing Metabolism

0 50 100 150 200 250 Number of proteins Increased Decreased

on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 Downloaded from http://iai.asm.org/ on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209 Downloaded from

100

80

60

40 http://iai.asm.org/ % Growth

20

0 0.32 0.16 0.08 0.04 0.02 0.01 0.005 0.0025

Concentration (µL/mL) on September 16, 2019 at UNIV OF WESTERN AUSTRALIA M209